Dignity is a useless concept

Editor

I read Professor Macklin’s editorial on the concept of dignity with
interest. [1] I agree that in strict legal-ethical terms the word has
little utility but it is a term that patients and relatives understand and
place value in. As with ‘obscenity’ dignity is hard to define but
instinctively understood.

When explaining to relatives the condition and likely outcome of
their loved one who is a patient in intensive care, it is difficult to
convey the suffering that the patient experiences. This is particularly
true when death appears inevitable and the suffering in vain. In this
situation, relatives readily appreciate that prolonging intensive care
support is preventing a ‘dignified’ death and may not be in the patient’s
best interest. They frequently volunteer that the patient him- or herself
would want to ‘die with dignity’.

I would submit therefore, that the word is of value to the clinician
if not to the ethicist.

Yours faithfully,

Dr Stephen J Fletcher

Consultant

Intensive Care Unit,
Bradford Teaching Hospitals,
Bradford BD9 6RJ

[1] Macklin R. Dignity is a useless concept. BMJ 2003;327:1419-20

Competing interests:
None declared